keyword
https://read.qxmd.com/read/33091620/polymyxin-monotherapy-versus-polymyxin-based-combination-therapy-against-carbapenem-resistant-klebsiella-pneumoniae-a-systematic-review-and-meta-analysis
#1
Si-Yuan Hou, Dan Wu, Xing-Huo Feng
OBJECTIVES: This meta-analysis was performed to compare polymyxin monotherapy and polymyxin-based combination therapy for carbapenem-resistant Klebsiella pneumoniae (CR-KP) infections. METHODS: We conducted searches on MEDLINE, Embase and Cochrane Collaborative database for both observational studies and randomised controlled trials (RCTs) comparing polymyxin monotherapy with polymyxin-based combination therapy in patients with CR-KP infection. The primary outcome was mortality...
October 19, 2020: Journal of Global Antimicrobial Resistance
https://read.qxmd.com/read/33090469/peri-operative-covid-19-infection-in-urgent-elective-surgery-during-a-pandemic-surge-period-a-retrospective-observational-cohort-study
#2
A D Kane, J Paterson, S Pokhrel, S K Berry, D Monkhouse, J W Brand, M Ingram, G R Danjoux
Maintaining safe elective surgical activity during the global coronavirus disease 2019 (COVID-19) pandemic is challenging and it is not clear how COVID-19 may impact peri-operative morbidity and mortality in this population. Therefore, adaptations to normal care pathways are required. Here, we establish if implementation of a bespoke peri-operative care bundle for urgent elective surgery during a pandemic surge period can deliver a low COVID-19-associated complication profile. We present a single-centre retrospective cohort study from a tertiary care hospital of patients planned for urgent elective surgery during the initial COVID-19 surge in the UK between 29 March and 12 June 2020...
October 22, 2020: Anaesthesia
https://read.qxmd.com/read/33090310/acute-respiratory-failure-in-immunocompromised-patients-outcome-and-clinical-features-according-to-neutropenia-status
#3
Djamel Mokart, Michael Darmon, Peter Schellongowski, Peter Pickkers, Marcio Soares, Jordi Rello, Philippe R Bauer, Andry van de Louw, Virginie Lemiale, Fabio Silvio Taccone, Ignacio Martin-Loeches, Jorge Salluh, Katerina Rusinova, Sangeeta Mehta, Massimo Antonelli, Achille Kouatchet, Andreas Barratt-Due, Miia Valkonen, Precious Pearl Landburg, Ramin Brandt Bukan, Frédéric Pène, Victoria Metaxa, Gaston Burghi, Colombe Saillard, Lene B Nielsen, Emmanuel Canet, Magali Bisbal, Elie Azoulay
BACKGROUND: The impact of neutropenia in critically ill immunocompromised patients admitted in a context of acute respiratory failure (ARF) remains uncertain. The primary objective was to assess the prognostic impact of neutropenia on outcomes of these patients. Secondary objective was to assess etiology of ARF according to neutropenia. METHODS: We performed a post hoc analysis of a prospective multicenter multinational study from 23 ICUs belonging to the Nine-I network...
October 22, 2020: Annals of Intensive Care
https://read.qxmd.com/read/33089061/right-atrial-thrombus-in-a-patient-with-covid-19-pneumonia-a-case-report
#4
Mohammed A Shamsah, Zouheir Ibrahim Bitar, Huda Alfoudri
Background: Significant coagulopathy and hyperinflammation are found in patients with coronavirus disease 2019 (COVID-19). Expert consensus has recommended prophylactic anticoagulation in COVID-19 patients due to the risk of thrombo-embolism. However, the use of therapeutic anticoagulation in these patients is still a matter of debate. Case summary: We describe a patient with COVID-19 pneumonia and a clinical hyperinflammatory state. He developed early respiratory depression and required ventilation, and he subsequently developed haemodynamic instability...
October 2020: European Heart Journal. Case Reports
https://read.qxmd.com/read/33089038/temporal-clinical-and-laboratory-response-to-interleukin-6-receptor-blockade-with-tocilizumab-in-89-hospitalized-patients-with-covid-19-pneumonia
#5
Daria S Fomina, Mar'yana A Lysenko, Irina P Beloglazova, Zinaida Yu Mutovina, Nataliya G Poteshkina, Inna V Samsonova, Tat'yana S Kruglova, Anton A Chernov, Alexander V Karaulov
Background: Pandemic COVID-19 pneumonia due to SARS-2 is an important cause of morbidity and mortality. Emerging evidence links poor outcomes to an inflammatory cytokine storm. Methods: We treated 89 hospitalized patients with COVID-19 pneumonia and heightened systemic inflammation (elevated serum C reactive protein and interleukin-6 levels) with an infusion of tocilizumab (TCZ), a human monoclonal IgG1 antibody to the interleukin-6 receptor. Results: Clinical and laboratory evidence of improvement was evident when baseline and 1-2-day post-infusion indices were compared...
2020: Pathogens & Immunity
https://read.qxmd.com/read/33087155/covid-19-what-iodine-maps-from-perfusion-ct-can-reveal-a-prospective-cohort-study
#6
Mario G Santamarina, Dominique Boisier Riscal, Ignacio Beddings, Roberto Contreras, Martiniano Baque, Mariano Volpacchio, Felipe Martinez Lomakin
BACKGROUND: Subtraction CT angiography (sCTA) is a technique used to evaluate pulmonary perfusion based on iodine distribution maps. The aim of this study is to assess lung perfusion changes with sCTA seen in patients with COVID-19 pneumonia and correlate them with clinical outcomes. MATERIAL AND METHODS: A prospective cohort study was carried out with 45 RT-PCR-confirmed COVID-19 patients that required hospitalization at three different hospitals, between April and May 2020...
October 21, 2020: Critical Care: the Official Journal of the Critical Care Forum
https://read.qxmd.com/read/33086927/risk-factors-and-prognosis-of-nosocomial-pneumonia-in-patients-undergoing-extracorporeal-membrane-oxygenation-a-retrospective-study
#7
Jianrong Wang, Jinyu Huang, Wei Hu, Xueying Cai, Weihang Hu, Ying Zhu
OBJECTIVE: We aimed to examine the risk factors and prognosis of nosocomial pneumonia (NP) during extracorporeal membrane oxygenation (ECMO). METHODS: We retrospectively analyzed data of patients who received ECMO at the Affiliated Hangzhou Hospital of Nanjing Medical University between January 2013 and August 2019. The primary outcome was the survival-to-discharge rate. RESULTS: Sixty-nine patients who received ECMO were enrolled, median age 42 years and 26 (37...
October 2020: Journal of International Medical Research
https://read.qxmd.com/read/33083556/pulmonary-complications-in-trauma-patients-with-obstructive-sleep-apnea-undergoing-pelvic-or-lower-limb-operation
#8
Michele Fiorentino, Franchesca Hwang, Sri Ram Pentakota, David H Livingston, Anne C Mosenthal
Background: Obstructive sleep apnea (OSA) is increasingly prevalent in the range of 2% to 24% in the US population. OSA is a well-described predictor of pulmonary complications after elective operation. Yet, data are lacking on its effect after operations for trauma. We hypothesized that OSA is an independent predictor of pulmonary complications in patients undergoing operations for traumatic pelvic/lower limb injuries (PLLI). Methods: Nationwide Inpatient Sample (2009-2013) was queried for International Classification of Diseases, Ninth Revision, Clinical Modification codes for PLLI requiring operation...
2020: Trauma Surgery & Acute Care Open
https://read.qxmd.com/read/33082958/efficacy-of-probiotics-in-the-prevention-of-vap-in-critically-ill-icu-patients-an-updated-systematic-review-and-meta-analysis-of-randomized-control-trials
#9
REVIEW
Priyam Batra, Kapil Dev Soni, Purva Mathur
Introduction: Ventilator-associated pneumonia (VAP) is reported as the second most common nosocomial infection among critically ill patients with the incidence ranging from 2 to 16 episodes per 1000 ventilator days. The use of probiotics has been shown to have a promising effect in many RCTs. Our systematic review and meta-analysis were thus planned to determine the effect of probiotic use in critically ill ventilated adult patients on the incidence of VAP, length of hospital stay, length of ICU stay, duration of mechanical ventilation, the incidence of diarrhea, and the incidence of oropharyngeal colonization and in-hospital mortality...
2020: Journal of Intensive Care
https://read.qxmd.com/read/33082112/epidemiology-mortality-and-risk-factors-for-patients-with-k-pneumoniae-bloodstream-infections-clinical-impact-of-carbapenem-resistance-in-a-tertiary-university-teaching-hospital-of-beijing
#10
Guojie Zhang, Meng Zhang, Fangyan Sun, Jiong Zhou, Yao Wang, Dawei Zhu, Zheng Chen, Qian Chen, Qing Chang, Haimin Liu, Wenzhao Chai, Hui Pan
BACKGROUND: This study compared the epidemiology of carbapenem-resistant (CRKP) and carbapenem-sensitive (CSKP) K. pneumoniae bloodstream infections (BSIs), and assessed risk factors for 28-day mortality of patients with K. pneumoniae BSIs. METHODS: A retrospective cohort study was conducted in a 2000-bed tertiary teaching hospital of Beijing between Jan 1st 2013 to Dec 31st, 2019. All patients with K. pneumoniae BSI were identified through the Hospital Information System...
October 17, 2020: Journal of Infection and Public Health
https://read.qxmd.com/read/33081900/-current-practice-and-obstacle-factors-of-intensive-care-unit-acquired-weakness-assessment
#11
Yuchen Wu, Biantong Jiang, Guoqiang Wang, Huaping Wei, Bin Li, Xiping Shen, Caiyun Zhang, Zhigang Zhang
OBJECTIVE: To investigate the current status of intensive care unit-acquired weakness (ICU-AW) assessment, analyze the assessment barriers, and to provide reference to improve ICU-AW assessment. METHODS: A convenient sampling cross-sectional survey was conducted. First, an interview outline which based on related domestic and international literatures and combining with the research purpose of this study were designed. Thirteen medical personnel (8 ICU nurses, 3 ICU doctors, 1 respiratory therapist and 1 physiotherapist) who worked in the intensive care unit (ICU) of the First Hospital of Lanzhou University were enrolled with convenience sampling method to interview...
September 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/33081895/-risk-factors-for-death-and-their-predictive-value-on-diabetic-kidney-disease-patients-in-intensive-care-unit-based-on-mimic-iii-database
#12
Shaolei Zhang, Rongqing Sun, Zhengrong Mao, Hongfu Yang, Dongwei Liu, Zhangsuo Liu
OBJECTIVE: To analyze the influencing factors of prognosis of patients with diabetic kidney disease (DKD) in intensive care unit (ICU), and analyze their predictive value. METHODS: Based on the inpatient information of more than 50 000 patients from June 2001 to October 2012 in the latest version of American Intensive Care Medical Information Database (MIMIC-III v1.4), the data of DKD patients were screened out, including gender, age, body weight, comorbidities [hypertension, coronary heart disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD)], sequential organ failure assessment (SOFA) score, the length of ICU stay, the incidence of mechanical ventilation, vasoactive drugs and renal replacement therapy during the ICU hospitalization, complications of other diseases [ventilator-associated pneumonia (VAP), urinary tract infection (UTI), diabetic ketoacidosis (DKA), acute myocardial infarction (AKI)] and prognosis of ICU...
September 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/33081892/-value-of-soluble-triggering-receptor-expression-on-myeloid-cells-1-level-of-alveolar-fluid-in-early-diagnosis-of-ventilator-associated-pneumonia-a-meta-analysis
#13
Jiayu Tan, Xiang Huang, Minzhi Wu, Bo Yang, Zhengchao Luo, Jingshan Li, Yuanfang Zhong, Zhenpeng Liang
OBJECTIVE: Serum soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) is a useful biomarker of bacterial infection. However, the diagnostic value of sTREM-1 of alveolar fluid in pulmonary infection is still unclear. This article aimed to explore the value of sTREM-1 of alveolar fluid in the early diagnosis of ventilator-associated pneumonia (VAP) by systematic review of relevant literatures. METHODS: CNKI, Wanfang, VIP, PubMed/Medline and Embase databases were retrieved...
September 2020: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://read.qxmd.com/read/33080877/effect-of-tocilizumab-in-hospitalized-patients-with-severe-covid-19-pneumonia-a-case-control-cohort-study
#14
Benjamin Rossi, Lee S Nguyen, Philippe Zimmermann, Faiza Boucenna, Louis Dubret, Louise Baucher, Helene Guillot, Marie-Anne Bouldouyre, Yves Allenbach, Joe-Elie Salem, Paul Barsoum, Arezki Oufella, Helene Gros
Tocilizumab, an anti-interleukin-6 receptor, administrated during the right timeframe may be beneficial against coronavirus-disease-2019 (COVID-19) pneumonia. All patients admitted for severe COVID-19 pneumonia (SpO2 ≤ 96% despite O2 -support ≥ 6 L/min) without invasive mechanical ventilation were included in a retrospective cohort study in a primary care hospital. The treatment effect of a single-dose, 400 mg, of tocilizumab was assessed by comparing those who received tocilizumab to those who did not...
October 17, 2020: Pharmaceuticals
https://read.qxmd.com/read/33080582/nitric-oxide-s-physiologic-effects-and-potential-as-a-therapeutic-agent-against-covid-19
#15
Fabio Luigi Massimo Ricciardolo, Francesca Bertolini, Vitina Carriero, Marieann Högman
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 pneumonia, a pandemic that precipitates huge pressures on the world's social and economic systems. Disease severity varies among individuals. SARS-CoV-2 infection can be associated with e.g. flu-like symptoms, dyspnoea, severe interstitial pneumonia, acute respiratory distress syndrome, multiorgan dysfunction, and generalized coagulopathy. Nitric oxide (NO), is a small signal molecule that impacts pleiotropic functions in human physiology, which can be involved in the significant effects of COVID-19 infection...
October 20, 2020: Journal of Breath Research
https://read.qxmd.com/read/33079651/immuno-informatics-based-peptides-an-approach-for-vaccine-development-against-outer-membrane-proteins-of-pseudomonas-genus
#16
Meshari Alazmi, Olaa Motwalli
Pseudomonas genus is among the top nosocomial pathogens known to date. Being highly opportunistic, members of pseudomonas genus are most commonly connected with nosocomial infections of urinary tract and ventilator-associated pneumonia. Nevertheless, vaccine development for this pathogenic genus is slow because of no information regarding immunity correlated functional mechanism. In this present work, an immunoinformatics pipeline is used for vaccine development based on epitope-based peptide design, which can result in crucial immune response against outer membrane proteins of pseudomonas genus...
October 20, 2020: IEEE/ACM Transactions on Computational Biology and Bioinformatics
https://read.qxmd.com/read/33079210/inflammasome-formation-in-the-lungs-of-patients-with-fatal-covid-19
#17
Stefano Toldo, Rossana Bussani, Vincenzo Nuzzi, Aldo Bonaventura, Adolfo G Mauro, Antonio Cannatà, Raghavendra Pillappa, Gianfranco Sinagra, Patrick Nana-Sinkam, Patricia Sime, Antonio Abbate
OBJECTIVE: The orf8b protein of the coronavirus SARS-CoV, analogous to SARS-CoV-2, triggers the NLRP3 inflammasome in macrophages in vitro. Deregulated inflammasome-mediated release of interleukin-1 family cytokines is important in hyper-inflammatory syndromes, like happens in SARS-CoV-2-mediated cytokine release syndrome. We propose that an intense inflammasome formation characterizes the lungs of patients with fatal COVID-19 disease due to pneumonia and acute respiratory distress syndrome (ARDS)...
October 20, 2020: Inflammation Research: Official Journal of the European Histamine Research Society ... [et Al.]
https://read.qxmd.com/read/33078076/factors-influencing-liberation-from-mechanical-ventilation-in-coronavirus-disease-2019-multicenter-observational-study-in-fifteen-italian-icus
#18
Lorenzo Gamberini, Tommaso Tonetti, Savino Spadaro, Gianluca Zani, Carlo Alberto Mazzoli, Chiara Capozzi, Emanuela Giampalma, Maria Letizia Bacchi Reggiani, Elisabetta Bertellini, Andrea Castelli, Irene Cavalli, Davide Colombo, Federico Crimaldi, Federica Damiani, Alberto Fogagnolo, Maurizio Fusari, Emiliano Gamberini, Giovanni Gordini, Cristiana Laici, Maria Concetta Lanza, Mirco Leo, Andrea Marudi, Giuseppe Nardi, Irene Ottaviani, Raffaella Papa, Antonella Potalivo, Emanuele Russo, Stefania Taddei, Carlo Alberto Volta, V Marco Ranieri
Background: A large proportion of patients with coronavirus disease 2019 (COVID-19) develop severe respiratory failure requiring admission to the intensive care unit (ICU) and about 80% of them need mechanical ventilation (MV). These patients show great complexity due to multiple organ involvement and a dynamic evolution over time; moreover, few information is available about the risk factors that may contribute to increase the time course of mechanical ventilation.The primary objective of this study is to investigate the risk factors associated with the inability to liberate COVID-19 patients from mechanical ventilation...
2020: Journal of Intensive Care
https://read.qxmd.com/read/33075034/impact-of-ventilator-associated-pneumonia-on-cerebrospinal-fluid-inflammation-during-immunosuppression-after-subarachnoid-hemorrhage-a-pilot-study
#19
Clément Coelembier, Fabienne Venet, Julie Demaret, Sébastien Viel, Jean-Jacques Lehot, Frédéric Dailler, Guillaume Monneret, Anne-Claire Lukaszewicz
INTRODUCTION: Brain injuries can cause systemic immunosuppression, which in turn can lead to infections that adversely affect the injured brain and worsen clinical outcomes. This study aimed to investigate whether systemic infection, such as ventilator-associated pneumonia (VAP), induce intracranial inflammation in patients with subarachnoid hemorrhage (SAH). METHODS: This prospective, observational study included 16 adults with SAH treated in the neuro-intensive care unit...
October 16, 2020: Journal of Neurosurgical Anesthesiology
https://read.qxmd.com/read/33072814/prolonged-low-dose-methylprednisolone-in-patients-with-severe-covid-19-pneumonia
#20
Francesco Salton, Paola Confalonieri, G Umberto Meduri, Pierachille Santus, Sergio Harari, Raffaele Scala, Simone Lanini, Valentina Vertui, Tiberio Oggionni, Antonella Caminati, Vincenzo Patruno, Mario Tamburrini, Alessandro Scartabellati, Mara Parati, Massimiliano Villani, Dejan Radovanovic, Sara Tomassetti, Claudia Ravaglia, Venerino Poletti, Andrea Vianello, Anna Talia Gaccione, Luca Guidelli, Rita Raccanelli, Paolo Lucernoni, Donato Lacedonia, Maria Pia Foschino Barbaro, Stefano Centanni, Michele Mondoni, Matteo Davì, Alberto Fantin, Xueyuan Cao, Lucio Torelli, Antonella Zucchetto, Marcella Montico, Annalisa Casarin, Micaela Romagnoli, Stefano Gasparini, Martina Bonifazi, Pierlanfranco D'Agaro, Alessandro Marcello, Danilo Licastro, Barbara Ruaro, Maria Concetta Volpe, Reba Umberger, Marco Confalonieri
Background: In hospitalized patients with coronavirus disease 2019 (COVID-19) pneumonia, progression to acute respiratory failure requiring invasive mechanical ventilation (MV) is associated with significant morbidity and mortality. Severe dysregulated systemic inflammation is the putative mechanism. We hypothesize that early prolonged methylprednisolone (MP) treatment could accelerate disease resolution, decreasing the need for intensive care unit (ICU) admission and mortality. Methods: We conducted a multicenter observational study to explore the association between exposure to prolonged, low-dose MP treatment and need for ICU referral, intubation, or death within 28 days (composite primary end point) in patients with severe COVID-19 pneumonia admitted to Italian respiratory high-dependency units...
October 2020: Open Forum Infectious Diseases
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